CEUS for prostate Cancer Localization

1. Introduction to CEUS 100%

Basics of Contrast Agents (e.g., SonoVue, Lumason)
Physics of Microbubbles and Harmonic Imaging
Advantages: Real-Time, Non-Ionizing, Repeatable
Applications in Tumor Imaging and Biopsy Guidance

2. CEUS Phases and Interpretation 100%

Arterial Phase (10–30 sec): Hypervascular Tumor Identification
Portal Phase (30–120 sec): Washout Evaluation
Late Phase (up to 5 min): Persistence or Loss of Enhancement
Enhancement Patterns: Rim, Centripetal, Mosaic, etc.

3. CEUS for Liver Cancer Localization 100%

Hepatocellular Carcinoma (HCC): Arterial Hyperenhancement + Late Washout
Cholangiocarcinoma: Rim Enhancement + Rapid Washout
CEUS LI-RADS Classification
Differentiation from Hemangioma, FNH, Cysts

4. CEUS in Kidney Tumors 100%

Clear Cell RCC: Intense, Early Enhancement
Papillary RCC: Hypovascular
Angiomyolipoma: No Washout
Indeterminate Complex Cysts (Bosniak III/IV)

5. CEUS for Prostate Cancer Localization 10%

Focal Early Enhancement in the Peripheral Zone
Identification of Suspicious Nodules Missed on Grey-Scale TRUS
Enhancement Timing: Tumor Shows Earlier and Stronger Enhancement than Normal Tissue
Microvascular Architecture Visualization: Disordered, Chaotic Vessels in Malignancy
Improved Targeting for TRUS-Guided Biopsy in Lesion-Directed Approach
Useful in Re-Biopsy Cases after Negative Systematic Biopsies
CEUS-mpMRI Fusion: Correlation and Added Sensitivity in Lesion Detection
Assessment of Tumor Volume and Extracapsular Extension (ECE)
CEUS Elastography Combination for Stiffness-Based Detection
Role in Monitoring Focal Therapy Outcomes (e.g., HIFU, Cryoablation)

6. CEUS in Other Organ Cancers 60%

Pancreas

Hypoenhancing Adenocarcinoma vs Hypervascular NETs
Guidance for EUS-FNA in Borderline Lesions

Thyroid

Irregular, Rapid Washout in Malignancy
Distinguishing Benign Nodules with Persistent Enhancement

Breast

Irregular Margins, Central Necrosis Patterns
Use in Dense Breasts and Pre-Biopsy Evaluation

7. CEUS-Guided Interventions 0%

Targeted Biopsy of Enhancing Lesions
Intra-procedural Localization for Ablation
Monitoring Ablation Zone Post-Treatment
Real-Time Adjustment Based on Enhancement Changes

8. Limitations and Pitfalls 0%

User Dependency and Learning Curve
Limited Role in Deep Lesions (Obesity/Gas Interference)
Misinterpretation of Benign Hyperenhancing Lesions
Microbubble Destruction Artifacts

9. Case Studies and Quiz Section 0%

Liver Tumor CEUS Interpretation Quiz
RCC vs AML CEUS Cases
Washout Pattern Analysis Practice
Doppler vs CEUS vs MRI Correlation Scenarios